Cytopathology Research Articles

Cytological, Histopathological and Immunohistochemical Studies on Naturally Occurring Cutaneous Melanomas in Cattle in and Around Namakkal, Tamil Nadu, India

Background: Melanomas are tumours that originate from melanoblasts. The studies on bovine tumours are of clinical concern since some melanocytic tumours are congenital and occur in young animals. The present work was carried out to study the pathomorphological characteristics of melanomas in cattle for early diagnosis and intervention. Methods: Tumour samples were collected from suspected cases of neoplasia from four animals during the study period. Data pertaining to the animals were collected. Fine needle aspiration cytology and impression smear were stained with Giemsa stain. Tissue samples were collected in 10 per cent neutral buffered formalin for histopathological examination. Special staining with Fontana silver stain and immunohistochemistry with Melan- A and S- 100 markers for confirmatory diagnosis of melanin pigment was done. Result: Cytology revealed neoplastic cells with vacuolation and pleomorphism. Cytoplasm contained abundant melanin pigments. Microscopically, the cytoplasm contained abundant brown, black coloured melanin pigment granules. Tissue sections stained with Fontana silver impregnation method revealed the presence of black coloured granules. Immunohistochemistry with Melan-A and S-100 revealed strong expression of brown coloured reaction in the cytoplasm of the neoplastic cells.

Correlation of VIA Positive Cases with Colposcopic and Histopathological Findings in Diagnosis of Precancerous Lesion of Cervix in A Tertiary Care Hospital

Background: Cervical cancer prevention strategies are evolving by integrating new screening modalities such as human papillomavirus (HPV) DNA testing and visual inspection with acetic acid (VIA). Colposcopy, as a diagnostic tool, plays a crucial role in the management of abnormal cytology smears, especially in developed countries. However, its utilization and efficacy in resource-limited settings like Bangladesh remain underexplored. Objective: This study aimed to assess the correlation between VIA positivity and colposcopic/histopathological findings in diagnosing precancerous cervical lesions among women in Bangladesh. Method: A cross-sectional study was conducted among 200 women aged 30-60 attending the Gynecology OPD of Dhaka Medical College and Hospital. VIA positivity was determined, and all positive cases underwent colposcopic evaluation. Histopathological examination was performed for tissue samples obtained during colposcopy. Result: Among the participants, 21% were VIA-positive. Colposcopic evaluation revealed inflammation (26.2%), CIN I (38.1%), CIN II (11.1%), CIN III (9.5%), and invasive carcinoma (9.5%). Histopathology findings included inflammation (28.6%), CIN I (40.5%), CIN II (7.1%), and invasive carcinoma (16.7%). True positive and false positive cases were identified, with percentages calculated accordingly. Conclusion: Detailed colposcopic evaluation with guided biopsy is crucial for detecting pre-invasive and early cervical cancer. Integrating colposcopy into screening programs in Bangladesh could significantly reduce morbidity and mortality among young women.

Study of p40 is superior to p63 for the diagnosis of pulmonary squamous cell carcinoma on cytological smears

Background: Histology and genetically driven management are the current standard in carcinoma lung. Adequate tissue is a challenge in a few cases. While liquid biopsy is an, it’s an always preferred to get an initial cyto/histo morphological confirmation. While the immune-histo chemistry (IHC) is a proven method to differentiate the squamous vs adeno carcinoma, the role of various “immuno-cyto-chemical” makers were not studied widely. Methods: This is a retrospective (July 2018 to December 2018) for random sample collection and prospective (Jan 2019-August 2019) study conducted from in the Department of pathology, govt. chest hospital Osmania medical college, Hyderabad as a part of PG dissertation, 120 subjects with cytological diagnosis of non-small cell lung carcinoma were analyzed during this period and others were excluded. Results: Out of 120 cases 80-adenocarcinoma (ADC) and 40-squamous cell carcinoma (SCC). Most of the patients are in 61-70 years, 20 are 71-80 years, 20 between 51-60 and 10 are between 40-50 years. In this study sensitivity of p63 and p40 is equal, but specificity and positive predictive value are higher for p40 for diagnosis of SCC. Conclusions: Immuno-cyto-chemistry is still a valid option in selected cases where getting a biopsy is difficult. Our findings recommend the use of p40 immuno staining rather than p63 as a squamous cell marker.

Exploring the barriers to Pap smear test compliance: A qualitative study for improving cervical cancer screening in the primary health care.

Cervical cancer in Iran ranks as the fourth most frequent cancer among women. Pap smear (PS) is the best standard for detecting cervical cancer, but many people, even healthcare providers (HCPs), do not maintain it. HCPs play a critical role in promoting PS uptake. The purpose of the study was to explore barriers to cervical cancer PS screening compliance from the HCPs' perspective. The present qualitative content analysis was conducted through semi-structured in-depth interviews. A total of 28 HCPs were interviewed between July and August 2020. A diverse sample of HCPs was selected using purposive sampling. Data analysis was based on the five steps proposed by Graneheim and Lundman. MAXQDA (2020) was used for data analyzing. Ten key sub-categories were identified and organized into three categories: individual, environmental, and socio-cultural factors. The sub-categories included inadequate risk perception, inappropriate attitude, low commitment, emotional factors, low priority over health, requirements and consequences of the test, deficiencies of health centers, organizational factors, traditions and religious believes. HCPs face multiple barriers for PS. Exploring and decreasing barriers of PS in HCPs may increase compliance in them and their clients because they play an influential role in instructing and persuading women to take the PS. There is need to explore these barriers and identify possible interventions to change them. Insights from this study are useful for developing policies around national PS programs, too.

Stem Cell-Derived Extracellular Vesicles in the Treatment of Cardiovascular Diseases.

Cardiovascular disease constitutes a noteworthy public health challenge characterized by a pronounced incidence, frequency, and mortality rate, particularly impacting specific demographic groups, and imposing a substantial burden on the healthcare infrastructure. Certain risk factors, such as age, gender, and smoking, contribute to the prevalence of fatal cardiovascular disease, highlighting the need for targeted interventions. Current challenges in clinical practice involve medication complexities, the lack of a systematic decision-making approach, and prevalent drug therapy problems. Stem cell-derived extracellular vesicles stand as versatile entities with a unique molecular fingerprint, holding significant therapeutic potential across a spectrum of applications, particularly in the realm of cardio-protection. Their lipid, protein, and nucleic acid compositions, coupled with their multifaceted functions, underscore their role as promising mediators in regenerative medicine and pave the way for further exploration of their intricate contributions to cellular physiology and pathology. Here, we overview our current understanding of the possible role of stem cell-derived extracellular vesicles in the clinical management of human cardiovascular pathologies.

Personality and the use of cancer screenings - Results of the German National Cohort

ObjectiveTo determine the association between personality characteristics and use of different cancer screenings. MethodsWe used data from the German National Cohort (NAKO; mean age was 53.0 years (SD: 9.2 years)) – a population-based cohort study. A total of 132,298 individuals were included in the analyses. As outcome measures, we used (self-reported): stool examination for blood (haemoccult test, early detection of bowel cancer), colonoscopy (screening for colorectal cancer), skin examination for moles (early detection of skin cancer), breast palpation by a doctor (early detection of breast cancer), x-ray examination of the breast (“mammography”, early detection of breast cancer), cervical smear test, finger examination of the rectum (early detection of prostate cancer), and blood test for prostate cancer (determination of Prostate-Specific Antigen level). The established Big Five Inventory-SOEP was used to quantify personality factors. It was adjusted for several covariates based on the Andersen model. Unadjusted and adjusted multiple logistic regressions were computed. ResultsA higher probability of having a skin examination for moles, for example, was associated with a higher conscientiousness (OR: 1.07, p < 0.001), higher extraversion (OR: 1.03, p < 0.001), higher agreeableness (OR: 1.02, p < 0.001), lower openness to experience (OR: 0.98, p < 0.001) and higher neuroticism (OR: 1.07, p < 0.001) among the total sample. Depending on the outcome used, the associations slightly varied. ConclusionsParticularly higher levels of extraversion, neuroticism and conscientiousness are associated with the use of different cancer screenings. Such knowledge may help to better understand non-participation in cancer screening examinations from a psychological perspective.

A Cytohistologic Correlation Study of Thyroid Lesions: Evaluation of Diagnostic Accuracy and Pitfalls of Fine Needle Aspiration Cytology.

Background Only about 5% of palpable thyroid nodules are malignant; the rest are entirely benign. In order to reduce the number of unnecessary treatments and properly identify situations that need surgical intervention, it is essential to distinguish between benign and malignant lesions prior to surgery. There exists a "grey zone" in thyroid cytology characterized by a significant decrease in diagnostic accuracy, making it difficult to precisely classify the lesion and leading to discrepancies. Aims and objectives The study aims to accomplish the following objectives: (1) assess the prevalence of thyroid lesions according to age and sex; (2) evaluate the accuracy of the fine needle aspiration cytology (FNAC) in diagnosing thyroid conditions; and (3) investigate the causes of cytohistological discordance within the context of this study. Materials and methods In our five-year study of thyroid lesions, 125 cases were studied for cytohistological correlation. Discrepant and likened FNAs were classified according to the diagnostic findings. A review of the cytological smears and histological sections was conducted. Results The cytological diagnoses were correlated with histopathology in 109 cases (90.83%). A total of 11 cases (09.16%) were discrepant. There were no false positives (FPs). The causes of false negative (FN) diagnoses in our study can be attributed to geographic misses and failure to recognize dual pathologies. Conclusion FNA is a very precise and time-saving technique for the diagnosis and subsequent management of palpable thyroid nodules. Patients having thyroidectomies have a much higher malignant yield, and the frequency of procedures performed on the thyroid is decreased. When FNA interpretation based on strict specimen sufficiency standards is considered along with clinical and imaging findings, the occurrence of FN and FP diagnoses is expected to decrease.

Human Leucocyte Antigen Class II Risk and Protective Alleles in Women with Cervical Intraepithelial Neoplasia.

Persistent human papillomavirus (HPV) infection is a necessary cause for development of cervical precancerous lesions and cervical cancer, however, only a small percentage of women progress to cervical cancer. The local immune response, determined, among other factors, by Human Leucocyte Antigen (HLA) genes, is thought to be significant. Still the results of genome studies are inconsistent and differ between ethnical populations. The aim of the study was to assess an association between HLA-DQA1*; DQB1*; DRB1* allele's genetic variants between women with cervical precancerous lesions and healthy controls in Latvia. From January until April 2017 we enrolled 84 consecutive patients referred for colposcopy to Riga East University Hospital (Latvia) due to abnormal cervical cytology results. 57 women who came for a regular check-up and had normal cytology smears were included in the control group. Material from the cervix was taken for subsequent HLA genotyping of 13 DRB1*, 8 DQA1*, and 12 DQB1* alleles. Colposcopy was performed on all participants. In case of visual suspicion for CIN cervical biopsy was done. There were 57 "no CIN" patients, 23 histologically proven CIN 1 and 61 CIN2+ cases in the study population. CIN2+ was more often associated with DQA1*0401 (OR 6.68, 95% CI 1.47-30.29, p=0.014), DRB*15 (OR 2.99, 95% CI 1.22-7.39, p=0.017), DQB1*0401 (OR 2.91, 95%CI 1.11-7.68, p=0.03), DQA1*0103 (OR 2.72, 95% CI 1.02-7.21, p=0.045), DRB1*11 (OR 2.42, 95% CI 1.10-5.33, p=0.029) and DQB1*0301 (OR 1.94, 95% CI 1.12-3.38, p=0.018). Women with "no CIN" more often had DQB1*0501 (OR 0.17, 95% CI 0.04-0.81, p=0.026), DRB1*16 (OR 0.21, 95% CI 0.06-0.78, p=0.019), DQA1*0301 (OR 0.35, 95% CI 0.14-0.87, p=0.024) and DRB1*14 (OR 0.59, 95% CI 0.01-0.46, p=0.007). In the current study we have demonstrated a strong association with risk and protective HLA class II alleles that are determined by the HLA-DRB1*; DQA1*; DQB1*.

(148) The Prevalence and Genotype Distribution of Human Papillomaviruses in Korean

Abstract Introduction Human papillomavirus (HPV) prevalence and genotype distribution are different between various nations and regions. Additionally, previous studies have mainly focused on HPV infection in western female and epidemiological studies of HPV infection in regional populations have been rarely reported. The lack of information on the HPV genotype distribution of the regional population in each individual country or region raises questions about the effectiveness of the current 9-valent vaccination. Objective To assess the prevalence and genotype of HPV(+) Korean and to know whether currently available 9-valent vaccine can cover the most prevalent and high risk genotype as HPV vaccine in Korean. Methods Between January 2014 to June 2022, samples of 44,065 men (Study I, M) and 564,499 females (Study II, F), who were volunteered for testing or recommended by a clinician, were tested for HPV detection and genotyping. Samples were collected swabs from the pap smear test. HPV detection and typing were conducted using the Anyplex™ II HPV 28 Detection system, which detects 19 high-risk (HR) HPVs and 9 low-risk (LR) HPVs. Results In Study I &amp; Study II, overall prevalence were 59.7% (M), 44.3%(F), prevalence of HR were 30.6%(M), 37.5%(F) and LR HPVs were 50.1%(M), 18.3%(F), respectively. Overall HPV prevalence was higher in teens (34.1% in M and 58.3% in F) and 20s (33.8% in M and 51.9% in F) with age [Table 1]. The most prevalent genotypes of HR were 16 (5.2%), 53 (4.6%), 51 (4.2%), 52 (3.8%), 58 (3.7%), 39(3.6%) and 66(3.4%) in Study I. In Study II of Female, the most prevalent genotypes of HR were 52 (7.1%), 53 (6.2%), 58 (5.0%), 68 (4.8%), and 16 (4.3%). In Study I of 26,299 men with HPV infection, 9,259 (35.2%) had a genotype with HR; 53 (4.6%), 51 (4.2%), 39(3.6%) and 66(3.4%), which could not prevented by the 9-valent vaccine. In Study II of 211,883 females with HPV infection, 72,252 (34.1%) had a genotype with HR, 68 (4.8%), 51 (4.1%), 39 (3.8%), and 56 (3.7%) which could not be prevented by the 9-valent vaccine. Conclusions In this study, Korea male and female aged under 30 years showed a high prevalence of HR HPVs. In both Male and Female groups, a significant number of HR HPVs infections were not prevented by 9-valent vaccine. Based on this result, it is necessary to develop nation-specific HPV vaccination for Korean. Further, this approach can be applied in other countries. Disclosure No.

Examination of Oral Candida Infection in Primary Sjögren's Syndrome Patients

Primary Sjögren's syndrome (pSS) is an autoimmune disease characterized by symptoms such as dry mouth, dry eyes, and other systematic symptoms. Due to the hyposalivation experienced by pSS patients, oral dysbacteriosis often occurs. A common complication of pSS is the oral Candida infection. In this article, the authors describe systematic methods that can effectively diagnose oral Candida infection and identify the Candida strains using saliva, oral mucosal swabs, or mouthwash from pSS patients. The Sabouraud's Dextrose Agar (SDA), hyphal formation assay, potassium hydroxide (KOH) smear test, and calcofluor white (CFW) staining assay are used for the diagnosis of oral Candida infection. A Candida diagnostic agar is used for the identification of Candida strains. Finally, antifungal susceptibility testing is used to determine appropriate antifungal drug treatment. This standardized method can enhance the diagnosis, treatment, and future research of pSS-related oral Candida infections. Early diagnosis, using this method, can also prevent any complications arising due to delay in receiving appropriate treatment.

PAP-test: Possibilities and Limitations

Cervical cancer (CC) progresses slowly, and the cytological screening increases the likelihood of early detection of precancerous lesions. Cytology of the cervix is one of the primary methods of effective CC diagnosis, which, thanks to early detection and timely treatment, leads to a stable decrease in morbidity and mortality from invasive CC. The results of many studies have shown that the specificity of the conventional Pap smear test is approximately 80–100%, its sensitivity ranges from 30% to 80%, and the rate of inadequacy of this method is from 5% to 25%. With traditional smear preparation, only a small percentage of collected cells end up on the slide, while abnormal cells may be discarded and not analyzed. When viewing the slide, cells that have dried and clumped together may interfere with the visualization of atypical cells. To overcome these limitations, in 1996, as an alternative to the traditional Pap test, liquid cytology was presented – the technology of preparing slides on which the cells are placed in a single layer. This technology outperformed the conventional Pap test with improved fixation, reduced obscuring factors, and standardized cell transfer. In liquid cytology samples are collected by fully immersing the cytobrush in a vial containing a preservative liquid, whereby the cells are preserved and fixed simultaneously, unlike conventional smears where the sample is applied to a glass slide and fixed separately. Today, two main methods of preparation based on liquid cytology are known: ThinPrep and SurePath. The results of cytology are described according to the Bethesda system. The Bethesda classification is widely accepted because it corresponds to the clinical presentation, reproduces the nature of the lesions, and is therefore treatmentoriented with a desirable follow-up procedure. The indisputable advantage of the Pap test by liquid cytology is the ability to perform both cytological and molecular studies, in particular HPV, in one sample. This capability facilitated the implementation of a two-step strategy when HPV testing is used as a triage test for ASC-US or low-grade squamous intraepithelial lesion cytology, or when cytology is used to triage HPV-positive women.

Nuclear Changes in Controlled and Uncontrolled Type-2 Diabetic Patients In Buccal Exfoliative Cytology Smears Using Pap And Giemsa Staining – A Comparative Study

Background: Diabetes is a third leading cause of mortality and morbidity in the world. Oral exfoliative cytology may be a more appropriate adjunctive diagnostic tool in conditions like diabetes mellitus, where the invasive techniques lose viability. Exfoliative cytology helps to detect cellular aging, cell atrophy, alterations in nucleus and cytoplasm, binucleation and occasional karyorrhexis in type-2diabetic patients which proves to be a valuable tool for early diagnosis of diabetes. The purpose of this research was to develop a new method for an early diagnosis of diabetes mellitus by exfoliative cytology using PAP stain and GIEMSA stains which is a nuclear specific stain. The aim of the study was to compare the exfoliative cytology of oral mucosa in controlled and uncontrolled type-2 diabetic patients using PAP stain and GIEMSA stain detect the nuclear and cytoplasmic changes. Materials And Methods: The smears were obtained from buccal mucosa of the mouth in total of 25 individuals out of which 10 are controlled (&lt;120 mg/dl) and 10 are uncontrolled (&gt;130 md/dl) diabetic patients and 5 normal individuals. These smear samples was obtained from the clinical lab of Saveetha Dental College. Results: The nuclear changes include nuclear bud, binucleate/micronucleate, karyolysis, increased nuclear cytoplasmic ratio &amp; hyperchromatism. The binucleated cells were found to have higher differences between controlled &amp; uncontrolled whereas karyorrhexis showed no significant changes between controlled &amp; uncontrolled diabetes. Conclusion: This is a preliminary study conducted to analyse the potential interaction between the nuclear changes and the amount of genetic damage caused in diabetes. However, our result clearly demonstrated that uncontrolled diabetic patients have significantly more genetic damage (in terms of MN frequency) compared to controlled diabetic patients. This indicates than MN may be a useful constituent in a panel of biomarkers for the risk of diabetes.

Diagnostic utility of intraoperative squash smear cytology of Intra-cranial lesions in a resource limited setup of central India

IntroductionIntraoperative squash smear cytology is a useful diagnostic tool in case of CNS lesions. In resource poor countries where frozen section is unavailable, cytology is the mainstay method in giving a rapid intraoperative diagnosis which helps Surgeons regarding the extent of excision. The current study aims to assess the feasibility and accuracy of intraoperative squash cytology in evaluation of CNS tumors. Definitive diagnosis is confirmed by histopathological examination. Materials and methodsThis retrospective observational study was carried out at Department of Neuropathology. All patients diagnosed with space occupying lesion (SOL) in CNS were enrolled in the study. Intra-operative cytological diagnosis was compared to histopathological diagnosis. WHO classification of CNS tumors 2021 was used to classify tumors. ResultsTotal seventy patients with intracranial SOLs were enrolled in this study who were operated for the same and their specimens were examined. Two samples were found to be inadequate and not included in final analysis. Mean age was 38.8 ± 17.85 (SD). Male–female ratio was 1.5:1 with 41 (60.3%) males and 27 (39.7%) females. 58 had neoplastic and rest 10 had non-neoplastic lesions. Complete concordance was achieved in 61 cases (Diagnostic Accuracy-88.2%). 3 (4.4%) cases showed partial concordance and 4 (5.9%) were discordant. For detection of malignant lesions through squash smear cytology overall Sensitivity was 73.9%, Specificity-97.8%, Positive Predictive Value-94.4% and Negative Predictive Value-88%. ConclusionsSquash smear cytology is a simple, rapid and cost-effective method relying solely on the expertise of pathologist. High diagnostic accuracy can be achieved with squash cytology by taking clinical and radiological findings into consideration.

Knowledge and Perceptions About Cervical Cancer and Human Papillomavirus, and Relationship with E-health Literacy, and Affecting Factors Among Female University Students.

Purpose: The aim of this study is to reveal female university students' knowledge and perceptions about cervical cancer (CC) and human papillomavirus (HPV), and relationship with e-health literacy (e-HL). It also aims to determine the predictors affecting CC and HPV. Methods: A cross-sectional study was conducted with 589 female university students in Türkiye. Data were collected using a "Cervical Cancer and HPV Awareness Questionnaire" and an "E-health Literacy Scale (e-HLS)." Analysis involved Pearson correlation analysis, Independent Sample t-test, one-way analysis of variance, and Linear Regression analysis. Results: Results indicate that female students exhibited a low level of knowledge and perception about CC and HPV. Only 2.90% of students reported being vaccinated, while 39.90% had sexual experience. Higher knowledge levels were observed among married individuals, those familiar with HPV and the HPV vaccine, those who had undergone Pap smear tests, sexually active individuals, and consistent condom users. e-HL had a positive impact on knowledge and perceived threat about CC and HPV. The affecting predictors for knowledge about CC and HPV were found to be e-HLS (β = 0.911), having prior knowledge of HPV (β = 0.201), and being aware of the HPV vaccine (β = 0.172). In terms of perceived threat, the affecting predictors were e-HLS (β = 0.207), having heard of HPV (β = 0.101), and having knowledge of the HPV vaccine (β = 0.092). Conclusion: e-HL emerged as a crucial predictor positively influencing knowledge and perceptions about CC and HPV. This suggests the potential for organizing digital health campaigns to enhance awareness and understanding of CC and HPV.

Women's views on content and delivery methods for interventions to improve preconception health: a qualitative exploration.

Systematic review evidence suggests preconception health interventions may be effective in improving a range of outcomes. However, few studies have explored women's views on potential content and delivery methods for these interventions. Participants were purposively sampled from respondents (n = 313) of a survey. Semi-structured, in-depth interviews were conducted to explore their views on seven candidate delivery methods for preconception health interventions: general practitioners (GPs), nurse practitioners, pharmacists, social media, personal texts and emails, pregnancy tests, and health education in schools. Data were analyzed using a data-driven framework analysis. Twenty women were interviewed. Women wanted interventions to be easily accessible but allow them to conceal their pregnancy plans. They preferred to choose to receive preconception interventions but were receptive to health professionals raising preconception health during 'relevant' appointments such as contraceptive counseling and cervical smear tests. They wanted intervention content to provide trustworthy and positively framed information that highlights the benefits of good preconception health and avoids stigmatizing women for their weight and preconception actions. The inclusion of support for preconception mental health and the use of visual media, personalization, simple information, and interesting and unfamiliar facts were viewed favorably. Interventions to improve preconception health should reflect the sensitivities of pregnancy intentions, be easy to access in a way that enables discretion, and be designed to seek consent to receive the intervention. These interventions should ideally be tailored to their target populations and provide trustworthy information from reputable sources. The potential for unintended harmful effects should be explored.

Idiopathic Portal Hypertension: A Case Report of an Adult Indian Rural Female of “Banti Syndrome”

Non-cirrhotic portal fibrosis (NCPF)/idiopathic portal fibrotic hypertension (IPH) is one of the major diseases that include a group of diseases caused by increased portal venous pressure which is thought to be due to intrahepatic or prehepatic lesions in the absence of liver cirrhosis. In the present case a 35-year-old female presented with abdominal fullness and pain in the upper abdomen for the past two months which was not associated with the consumption of water or food, nausea, or vomiting. When we investigated it was seen that she had severe anemia with pancytopenia with no malarial parasite on peripheral smear, liver renal and liver function tests were within the normal range. The diagnosis of Banti’s syndrome was made. However, the patient was then vitally stable and was started on propranolol and was advised for splenectomy due to refractory anemia. The present study provides easy and conventional diagnostic techniques for clinical diagnosis and proves the radiological technique.

Correlation Serum Vitamin D with Level of control of Childhood Asthma

Background: Childhood asthma is the most prevalent chronic condition in children, and it, like many other chronic illnesses, has a significant impact on the social and emotional life of children and their families. Objectives: To study the correlation of Serum Vitamin D With Level Of Control Of Childhood Asthma. Methods: A comprehensive clinical history was taken, including the child's dietary patterns and the amount of hours spent outside during the day to assess the child's exposure to sunshine. An evaluation of the respiratory system was carried out. The child's nutritional status was determined using WHO growth charts. Diagnostic investigations like Chest x-ray, complete blood count (CBC), erythrocyte sedimentation rate (ESR), absolute eosinophil count (AEC), nasal smear cytology, Peak Expiratory Flow Rate (PEFR), and spirometry were all performed. Results: A total of 150 children with Asthma were divided into groups based on severity, The Intermittent (n=34), mild persistent (n=93), moderate persistent (n=23) and severe persistent (n=0), Since there was no case classified in the severe persistent group only 3 groups were classified. Intermittent: Out of 34 children having intermittent asthma severity, Vitamin- D was deficient in 35.29% of the cases, Insufficient in 17.64% of the cases, Sufficient in 47% of the cases. Mild Persistent: Out of 93 children having mild persistent asthma severity, Vitamin- D was deficient in 58% of the cases, Insufficient in 19.35% of the cases, Sufficient in 22.58% of the cases. Moderate Persistent: Out of 23 children having moderate persistent asthma severity, Vitamin-D was deficient in 56.5% of the cases, Insufficient in 17.39% of the cases, Sufficient in 26% of the cases. Conclusion: Asthmatics have a significant prevalence of Vitamin D deficiency and insufficiency. Although there was no significant relationship between asthma severity and Vitamin D levels, low Vitamin D levels were correlated to a protracted duration of illness and a larger proportion of exacerbations, suggesting that Vitamin D may have a role in asthma exacerbations.

Crystallizing galactocele: A rare case report and review of literature.

Crystallizing galactocele is an uncommon condition that produces a viscous, chalky substance on fine needle aspiration cytology. (FNAC). Both the diagnosis and the management of this illness include the use of FNAC. Here, we discuss the case of a 25-year-old nursing woman who experienced left breast edema lump for two years. The upper outer quadrant of the leftt breast was involved by the hard, small, non-tender, and movable enlargement. The lesion's FNAC produced a thick, milky, and chalky substance. Numerous semi-transparent crystals of various sizes and shapes with angulated edges could be seen in cytological smears against a background of granular and amorphous proteinaceous material. A diagnosis of crystallizing galactocele was made on the basis of the patient's clinical history of lactation and characteristic cytological findings. Due to the rarity of this condition-to the best of our knowledge, less than ten cases of crystallizing galactocele have been documented in medical literature.

Enhancing cervical cancer diagnosis with graph convolution network: AI-powered segmentation, feature analysis, and classification for early detection

Cervical cancer is a prevalent disease affecting the cervix cells in women and is one of the leading causes of mortality for women globally. The Pap smear test determines the risk of cervical cancer by detecting abnormal cervix cells. Early detection and diagnosis of this cancer can effectively increase the patient’s survival rate. The advent of artificial intelligence facilitates the development of automated computer-assisted cervical cancer diagnostic systems, which are widely used to enhance cancer screening. This study emphasizes the segmentation and classification of various cervical cancer cell types. An intuitive but effective segmentation technique is used to segment the nucleus and cytoplasm from histopathological cell images. Additionally, handcrafted features include different properties of the cells generated from the distinct cervical cytoplasm and nucleus area. Two feature rankings techniques are conducted to evaluate this study’s significant feature set. Feature analysis identifies the critical pathological properties of cervical cells and then divides them into 30, 40, and 50 sets of diagnostic features. Furthermore, a graph dataset is constructed using the strongest correlated features, prioritizes the relationship between the features, and a robust graph convolution network (GCN) is introduced to efficiently predict the cervical cell types. The proposed model obtains a sublime accuracy of 99.11% for the 40-feature set of the SipakMed dataset. This study outperforms the existing study, performing both segmentation and classification simultaneously, conducting an in-depth feature analysis, attaining maximum accuracy efficiently, and ensuring the interpretability of the proposed model. To validate the model’s outcome, we tested it on the Herlev dataset and highlighted its robustness by attaining an accuracy of 98.18%. The results of this proposed methodology demonstrate the dependability of this study effectively, detecting cervical cancer in its early stages and upholding the significance of the lives of women.

Interstitial cystitis – a diagnostic dilemma: A case report

Background: Interstitial cystitis is a debilitating condition with a rising prevalence due to increasedresearch and diagnostic criteria. Interstitial cystitis falls under the category of urologic chronic pelvic painsyndrome and is a diagnosis of exclusion. Interstitial cystitis or bladder pain syndrome (BPS) ischaracterized by chronic inflammation. Common symptoms include chronic pelvic pain, pressure, ordiscomfort perceived to be related to the urinary bladder accompanied by other urinary symptoms, suchas persistent urge to void or urinary frequency in the absence of confusable diseases (hypersensitivebladder symptoms). The true burden of interstitial cystitis is underestimated, and the economic burden ofthe disease is due to multiple office visits and an increase in direct medical costs.Case presentation: A 59-year-old para 2+0 (2 previous scars) postmenopausal with a 1-year history offrequency (up to eight episodes) nocturia with low abdominal pain. Her urinalysis profile, urea,electrolytes and creatinine, and ultrasound and computed tomography of the kidneys, ureters andbladder, pap smear, and random blood sugar tests were unremarkable. Cystoscopy was hemorrhagicwith biopsy histology showing ulcerated bladder mucosa with numerous plasma cells, eosinophils, andneutrophils in the lamina propria no atypia, with fibrosis and dilated capillaries in the lamina propria. Onfollow-up she had a recurrence of pain symptoms with a cystoscopy biopsy, seven months later showingplasma cell infiltrate with ulceration of the overlying urothelium, and congestion of the blood vessels. Shewas not neoplastic and was put on antihistamine, nonsteroidal antiinflammatory drugs, and solifen.Conclusion: Prompt diagnosis and treatment of interstitial cystitis will reduce the burden of diseaseassociated with multiple outpatient visits and unnecessary use of antibiotics. The mainstay ofmanagement is oral and intravesical treatment with surgery in refractory cases.